Abstract
Background–Temperatures in the harsh summer times of Kuwait commonly exceed 40°C during the day. Since 2015, a ministerial law banned employees from working under the sun (11am to 4pm) from June 1st to August 31st of every year. The vast majority of the affected employees are migrant workers in outdoor jobs such as construction and hospitality. Aim–We assessed the risk of occupational injuries associated with outdoor extreme hot temperatures during the summertime ban period in Kuwait. Methods–We collected daily occupational injuries that are reported to the Ministry of Health’s Occupational Health Department for five years from 2015 to 2019. We examined counts of occupational injuries during the same summertime ban period from June 1st to August 31st in each of the five years. We fitted generalized additive models with a quasipoisson distribution in a time series design. A 7-day moving average of daily mean temperature was modelled with penalized splines adjusted for relative humidity, time trend and day of the week. Results–During the June-August summertime ban, the daily average temperature was 39.4°C(±1.8°C). There were 7.2, 7.6 and 9.4 reported injuries per day in the summer months of June, July and August, respectively. The exposure-response relationship was S-shaped with a decrease in risk at very extreme hot temperatures. Compared to the 10th percentile of summer temperatures in Kuwait (37.4°C), the average day with a temperature of 39.4°C increases the risk of injury by 1.38-fold (95% confidence intervals: 1.30-1.46). Similarly, temperatures of 40°C and 41°C were associated with relative risks of 1.41 (1.33-1.49) and 1.34 (1.21-1.49), respectively. The risks leveled off at 42°C (relative risk 1.21; 0.93-1.57). Conclusions–We found substantial increases in occupational injury risk from extremely hot temperatures despite the summertime ban in Kuwait. Calendar-based rather than heat- or risk-based regulation may be inadequate to provide occupational protections for migrant workers.
Published Version
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